A pilot study assessing the use of stem cells to enhance recovery following stroke

Institution:
Division of Stroke Medicine, University of Nottingham, Nottingham City Hospital
Principal Investigator:
Professor Philip Bath
Region: East Midlands
Grant value: £59,589 over 24 months
Start date: January 2004
Status: ongoing

Stroke often leads to loss of movement despite rehabilitation programmes. As bone marrow stem cells are capable of self renewal and changing into different cell types it has been suggested in previous studies that these could be transplanted into stroke patients to help their brains replace lost cells.
This would be difficult to achieve directly into the brain, so stem cells could be released into the circulation using a manufactured version of natural substance, granulocyte-colony stimulating factor (G-CSF), a drug that is routinely used in the treatment of patients with cancer.
The current study will involve a pilot trial investigating the effects of G-CSF on patients with weakness following stroke. It will focus on the safety, ease of administration, tolerability, ability to mobilize marrow stem cells and effect on recovery of arm and leg movement. The study will last 24 months, with 42 patients recruited from Nottingham City Hospital over 19 months. The results will help in the design of further and larger experiments.
If G-CSF is cost effective in increasing rates of recovery it could be used routinely in the rehabilitation of patients with recent disabling stroke.

Scientific Title: A randomized placebo controlled pilot trial of granulocyte-colony stimulating factor in mobilizing bone marrow stem cells in subacute stroke: the ‘Stem cell Trial of recovery EnhanceMent after Stroke’ (STEMS) pilot study

With thanks to the TR Golden Charitable Trust for supporting this award.

Classification:
Neurorehabilitation, Rehabilitation

Publications:

N Sprigg, PM Bath, L Zhao, MR Willmot, LJ Gray, MF Walker, M Dennis, N Russell. Granulocyte-colony stimulating factor mobilises bone marrow stem cells in patients with sub-acute ischaemic stroke: the 'Stem cell Trial of recovery EnhanceMent after Stroke' (STEMS) pilot randomised controlled trial. Stroke, 37(12);2979-83